Saturday, November 21, 2009

One. NewFNP is fucking stoked not to have a mammogram again until age fifty. Not so nuanced a comment, but personal indeed.

Two. NewFNP was leaving Whole Paycheck with bag full of organic goodies and was listening a gentleman on NPR listing the reasons for opposition to health care reform. One reason was the loss of choice. (He didn't specify, but newFNP assumes that he is talking about choice over health care providers as well as the government having a say in what health care can and cannot be provided.) Oh, the irony! After all, isn't there a huge brouhaha over including the choice to have an abortion in the current health care reform debate??!

Saturday, November 14, 2009

NewFNP doesn't need to be convinced of anyone's reasons for seeking abortion - she has been pro-choice for as long as she knew that the issue existed.

But when newFNP met a young woman in clinic this week, she thought to herself, "Now this is a person who should have an abortion." This young woman is 20-years old. She was pregnant for the ninth time and did not care. According to her, she has had seven miscarriages - some of them provoked but she declined to elaborate further. She is bipolar and unmedicated. She is homeless. The father of this baby is incarcerated. She smokes one pack of cigarettes daily. Until a few weeks ago, she regularly used methamphetamine. She was carrying a prescription for Haldol due to her recent suicide attempt.

The one child who she carried to term is in foster care. She opted for foster care rather than adoption because - in her words - adoptive families get too close to the kid. Yeah, newFNP is pretty sure that that is the point of adoption.

So -- chronically homeless and chronically mentally ill. Polysubstance use. In the best of circumstances, a new baby is challenging. This young woman was not experiencing the best of circumstances.

NewFNP hopes that the foster care system in which her six-month old child is placed finds this baby a loving adoptive family who will raise her with love and assuage the effects of the tumultuous pregnancy and the family history of mental illness and drug addiction.

And she hopes that this mom will terminate this pregnancy and will seek birth control services, mental health services, substance abuse treatment and housing. Maybe one day she will be able to care for herself and a pregnancy. But this is not that day.

This blog is for new NPs or NP students who want some real 411 on the life of a new practitioner. A new practitioner in a busy, understaffed, urban community health clinic in a major metropolitan area. Oh, and newFNP swears while writing and, sometimes, while working although she tries to keep those swears to herself. Consider yourself warned.